Individual provider Active NPI

Jason A Coffey, MD

  • Emergency Medicine Physician
  • Hickory, NC
National Provider Identifier
1477515633
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200001101 Issued in NC
Practice address
420 N Center St
Hickory, NC 28601-5046
Phone
(828) 315-5000
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200001101 NC Primary

Addresses

Primary practice location

420 N Center St
Hickory, NC 28601-5046

Mailing address

PO Box 643822
Cincinnati, OH 45264-3822
Phone (800) 599-0207

Other identifiers 3

IdentifierTypeStateIssuer
89128RVMedicaidNC
128RVOtherNCBCBS
P00251739OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726001204 NC Practitioner - Emergency Medicine 5395772883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frye Emergency Medical Associates LLCGroup PAC ID 1557398609, 18 clinicians

Practice addresses (Care Compare)

420 N Ctr St
Hickory, NC 28601-5033
Phone (704) 660-4055

Hospital & facility affiliations

  • Frye Regional Medical Center Hospital, Hickory, NC, CCN 340116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200001101NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frye Emergency Medical Associates LLC Emergency Medicine CurrentSince Aug 1, 2005 Accepting new patients
Blue Ridge Emergency Medical Associates LLC Emergency Medicine Past Accepting new patients

Locations

420 N Center St
Hickory, NC 28601
Phone (704) 660-4055

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1477515633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643822",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452643822",
            "telephone_number": "800-599-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015046",
            "telephone_number": "828-315-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200001101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128RV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "128RV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00251739",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.